Career advice for savvy 21st-century nurses from holistic career coach Nurse Keith

Friday, July 27, 2012

Of Tragedy, Heroism and Recovery

In the wake of the recent mass shooting in Aurora, Colorado,
our hearts indeed go out to the victims, their families and loved ones, and the
many people impacted by this horrific and inexplicably nefarious event. When
senseless terror such as this is visited on innocent citizens, it is a shocking
reminder of the ways in which violence can tear open the heart of a
community—and a nation—in a matter of moments.

When events like this occur in our midst, we frequently do
not consider the impact that it has on the first responders who initially
respond to such traumatic events, as well as the hospital staff, surgeons and
nurses who deal with the (often prolonged and painful) aftermath.

In September of 2001, the entire world learned of the
heroism of the New York City firefighters and other first responders who
charged up the smoky stairwells of the burning World Trade Center, and many of
those courageous individuals gave their lives in the line of duty on that
unforgettable day.

Since I’m a nurse who coaches and advises nurses on self
care, burnout prevention and overall health and wellness, I’d like to take a
moment to consider how nurses and their healthcare colleagues themselves react
to such traumatic events, especially when standing on the front lines.

When trauma victims such as those in Aurora are transported
by ambulance to a nearby emergency department, the ED staff are often notified
of what they might expect and hopefully have time to begin preparing before the
critically injure patients begin to arrive.

In the case of the Aurora massacre, one can only imagine
what might be going through the minds of the nurses and other staff members of
the hospitals on the receiving end of the racing ambulances. Were their friends and neighbors among the
dead or injured? Would a colleague be one of the critical patients rushed from
the scene in need of life-saving assistance? How would it feel to see a
favorite teacher or local barista bloodied and fighting for her life as the
sirens announced their arrival through the emergency department doors?

The military understands the effects of such secondary
trauma, and their crisis debriefing models developed over the decades can be
skillfully used to debrief first responders, nurses, medical staff and others from the
horrific scenes to which they are often witness. Some seasoned nurses and
medical professionals may be somewhat inured to such sights and experiences, but it can take a
toll over time, and learning how to walk the mind and heart through these types
of exposures is an important skill to master.

Yes, we grieve and we feel deeply for the individuals who
have been injured, maimed, killed, and traumatized. We mourn and pray with
their families, loved ones, friends and colleagues as everyone connected with
such tragedy attempts to come to grips with such an event and make sense of it
in whatever way seems possible.

We also want to remember those who ran into that theater and
faced the initial shock of the bloody scene before them, as well as those who
administered first aid, recovered the dead, and transported the injured to the facilities where they could best be cared for--and hopefully saved.

Once delivered safely to the local hospitals that were ready
to receive the victims, it was the medical staff—nurses, doctors, surgeons and
others—who then bore the brunt of the secondary trauma as they struggled in
haste to salvage lives shattered by unanticipated and inexplicable violence.
And the presence of children among the injured and dead is simply another layer
of trauma and shock that is even greater to digest and accept.

The ripple of trauma is wide in a scenario such as Aurora,
and we hope that the paramedics, nurses, surgeons and others who treated—and
are still treating—the injured are taking care of themselves even as they care
for those in need of their professional skills and expertise.

Those frontline medical personnel need to remember to
hydrate well, eat nutritious food, take time for self care, practice good sleep
hygiene, and spend time away from work where the stresses of this traumatic
event can be briefly set aside.

For those who are prone to give until it hurts—and then give
some more—it’s a high priority to get away, debrief with friends, family and
colleagues, and allow the nervous system to recalibrate.

Laughter and play (yes, even under these circumstances),
exercise, hydration, good nutrition, rest, and other positive actions and
experiences can help to mitigate the effects of stress and trauma.

When under the effects of such experiences, cortisol and
other stress hormones flood the circulation, and hydration and cardiovascular
exercise are two of the best ways to flush these chemicals from the body while
enhancing the production and secretion of dopamine and other chemicals that
counterbalance the deleterious effects of stress on the human system.

Short-term crisis counseling or a professional crisis
debriefing can also be very helpful at times such as these. Likewise, grief
specialists can add a particular caliber of understanding and normalization
when individuals impacted by trauma are reacting to such unusual and
potentially life-altering circumstances. These professional counselors will
tell all survivors and witnesses that any reaction is normal in grossly
abnormal situations such as this, and patience and tenderness are called for in
the days and weeks to come.

This advice can be equally applied to the families and
friends of the Aurora victims, and time is one of the best healers when trauma
has paid an unexpected visit.

We hold the victims and their loved ones in our hearts, and
we equally send our support and wishes for self care and well-deserved rest to
those who helped to save and mend the innocent individuals caught in the
inexplicable crossfire in Aurora.

Everyone affected by this event needs healing, whether they
are direct victims of the shooting, friends and family of the victims, or the
professionals and others who somehow cared for those individuals.

Self care is paramount at such times, and as difficult as it
can be, every person traumatized by these events must be sure to treat
themselves and their loved ones with the utmost kindness, gentleness and
compassion. And for the nurses and healthcare professionals giving their all
when it’s needed the most, this advice could not be more timely nor important.

Everyone will need to move on from this tragedy. Having said
that, moving on in a healthy and thoughtful way is essential for long-term
recovery and the resumption of a life that has been unfortunately and
inexplicably touched by pointless, senseless and tragic violence.

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